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Fontenot HB, Quist KM, Glauberman G, Michel A, Zimet G. Impact of the COVID-19 pandemic on social media utilization, influences related to parental vaccine decision making, and opinions on trustworthy social media vaccination campaigns: A qualitative analysis. Hum Vaccin Immunother 2024; 20:2311476. [PMID: 38356267 PMCID: PMC10878019 DOI: 10.1080/21645515.2024.2311476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 01/25/2024] [Indexed: 02/16/2024] Open
Abstract
There is a continued need for research to better understand the influence social media has on parental vaccination attitudes and behaviors, especially research capturing the effects of the COVID-19 pandemic. The goal of this study was to explore parents' perspectives related to the impact the pandemic had on 1) social media engagement, 2) vaccine messaging on social media, and 3) factors to guide future intervention development. Between February and March 2022, 6 online, synchronous, text-based focus groups were conducted with parents of adolescents aged 11 to 17 years. Participants who all utilized social media were recruited from across the United States. Qualitative data were analyzed using content analysis. A total of 64 parents participated. Average age was 47 years, and participants were predominantly White (71.9%), female (84.3%), and engaged with social media multiple times per day (51.6%). Participants (95.3%) viewed obtaining all recommended vaccines as important or very important; however, overall vaccination rates for their adolescents were varied (50% ≥1 dose HPV; 59.4% MenACWY; 78.1% Tdap; 65.6% Flu; 81.3% COVID-19). Three themes emerged highlighting the pandemic's impact on parent's (1) general patterns of social media use, (2) engagement about vaccines on social media and off-line behaviors related to vaccination, and (3) perspectives for developing a credible and trustworthy social media intervention about vaccination. Participants reported fatigue from contentious vaccine-related content on social media and desired future messaging to be from recognizable health institutions/associations with links to reputable resources. Plus, providers should continue to provide strong vaccine recommendations in clinic.
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Affiliation(s)
| | - Kevin M. Quist
- Department of Pediatrics, Herman B Wells Center for Pediatric Research, Indianapolis, IN, USA
| | - Gary Glauberman
- School of Nursing, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Alexandra Michel
- School of Nursing, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Gregory Zimet
- Department of Pediatrics, Division of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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Michel AD, Fontenot HB, Fuzzell L, Brownstein NC, Lake P, Vadaparampil ST, Perkins RB. Attitudes toward the American Cancer Society's 2020 cervical cancer screening guidelines: A qualitative study of a national sample of US clinicians. Cancer 2024. [PMID: 38436396 DOI: 10.1002/cncr.35269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/11/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND The 2020 American Cancer Society (ACS) guidelines are the most recent national guidelines for cervical cancer screening. These guidelines propose two major changes from current practice: initiating screening at age 25 years and using primary human papillomavirus (HPV) testing. Adoption of guidelines often occurs slowly, and therefore understanding clinician attitudes is important to facilitate practice change. METHODS Interviews with a national sample of clinicians who perform cervical cancer screening in a variety of settings explored attitudes toward the two major changes from the 2020 ACS cervical cancer screening guidelines. Clinicians participated in 30- to 60-min interviews exploring their attitudes toward various aspects of cervical cancer screening. Qualitative analysis was performed. RESULTS Seventy clinicians participated from across the United States. Few respondents were initiating screening at age 25 years, and none were using primary HPV testing. However, over half would be willing to adopt these practices if supported by scientific evidence and recommended by professional medical organizations. Barriers to adoption included the lack of endorsement by professional societies, lack of laboratory availability and insurance coverage, limited autonomy within large health care systems, and concerns related to missed disease. CONCLUSIONS Few clinicians have adopted screening initiation or primary HPV testing, as recommended by the 2020 ACS guidelines, but over half were open to adopting these changes. Implementation may be facilitated via professional organization endorsement, clinician education, and laboratory, health care system, and insurance support. PLAIN LANGUAGE SUMMARY In 2020, the American Cancer Society (ACS) released updated guidelines for cervical cancer screening. The main changes to current practices were to initiate screening at age 25 years instead of age 21 years and to screen using primary human papillomavirus (HPV) testing rather than cytology alone or in combination with HPV testing. We performed in-depth interviews with 70 obstetrics and gynecology, family medicine, and internal medicine physicians and advanced practice providers about their attitudes toward these guidelines. Few clinicians are following the 2020 ACS guidelines, but over half were open to changing practice if the changes were supported by evidence and recommended by professional medical organizations. Barriers to adoption included the lack of endorsement by professional medical organizations, logistical issues, and concerns about missed disease.
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Affiliation(s)
- Alexandra D Michel
- College of Nursing, Rosalind Franklin University, North Chicago, Illinois, USA
| | - Holly B Fontenot
- School of Nursing, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Lindsay Fuzzell
- Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Naomi C Brownstein
- Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Paige Lake
- Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Susan T Vadaparampil
- Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Rebecca B Perkins
- Chobanian & Avedisian School of Medicine, Boston University, Boston, Massachusetts, USA
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McKay EA, Mattheus D, Garney WR, Wilson KL, Fontenot HB. Development of Youth-Centered Health Messaging Posters for High School-Based Health Clinics in Hawaii. J Sch Health 2024; 94:251-258. [PMID: 37985932 DOI: 10.1111/josh.13411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 07/19/2023] [Accepted: 10/19/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Youth may be reluctant to seek health care from school health providers due to feeling embarrassed or stigmatized in the health office environment or worried about their confidentiality. The purpose of this project was to create a set of youth-centered health posters that promote youth engagement with nursing staff and to standardize health messaging across high schools in Hawaii school-based clinics. METHODS Two community advisory boards, 1 composed of 10 youth stakeholders (mean age 17 years) and the other of 7 adult stakeholders, informed poster development utilizing web-based discussion groups. The discussions were transcribed, and additional data was collected using field notes and anonymous digital messages. Adult advisory board members also provided feedback on suggested poster text through an online survey. RESULTS Youth and adult advisory board participants identified 4 key health concerns facing youth: confidentiality, sexual health, relationships, and mental health. Based on input from the 2 advisory boards, 4 posters were developed, each centered on 1 key health issue. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY School-based posters can convey important messages to help youth understand their health care rights and responsibilities, as well as identify important issues open for discussion with nurses. CONCLUSION Posters are an underutilized tool for school health providers to create welcoming, inclusive health care environments and facilitate health-related conversations with youth. This paper describes participant feedback about the characteristics of a memorable poster and briefly outlines current knowledge and recommendations for school health providers regarding each of the 4 health issues.
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Affiliation(s)
- Elizabeth A McKay
- University of Massachusetts, Lowell, Solomont School of Nursing, 113 Wilder St, Lowell, MA, 01854
| | - Deborah Mattheus
- University of Hawaii at Manoa, School of Nursing; 2528 McCarthy Mall, Webster Hall, Honolulu, HI, 96822
| | - Whitney R Garney
- Texas A&M University, School of Public Health, 212 Adriance Rd, College Station, College Station, TX, 77843-1266
| | - Kelly L Wilson
- Texas A&M University, School of Nursing, 8447 Riverside Pkwy, Bryan, TX, 77807
| | - Holly B Fontenot
- University of Hawaii at Manoa, School of Nursing; 2528 McCarthy Mall, Webster Hall, Honolulu, HI, 96822
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Perkins RB, Fuzzell L, Lake P, Brownstein NC, Fontenot HB, Michel A, Whitmer A, Vadaparampil ST. Factors Associated With Guideline-concordant and Excessive Cervical Cancer Screening: A Mixed Methods Study. Womens Health Issues 2024:S1049-3867(24)00001-X. [PMID: 38383228 DOI: 10.1016/j.whi.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/21/2023] [Accepted: 01/09/2024] [Indexed: 02/23/2024]
Abstract
INTRODUCTION National guidelines recommend cervical cancer screening with Papanicolaou (Pap) testing at 3-year intervals or with human papillomavirus (HPV) testing alone or HPV/Pap cotesting at 5-year intervals for average-risk individuals aged 30-65 years. METHODS We explored factors associated with clinician-reported guideline-concordant screening, as well as facilitators and barriers to appropriate cervical cancer screening. RESULTS A national sample of clinicians (N = 1,251) completed surveys; a subset (n = 55) completed interviews. Most (94%) screened average-risk patients aged 30-65 years with cotesting. Nearly all clinicians who were categorized as nonadherent to national guidelines were overscreening (98%). Guideline concordant screening was reported by 47% and 82% of those using cotesting and HPV testing, respectively (5-year intervals), and by 62% of those using Pap testing only (3-year intervals). Concordant screening was reported more often by clinicians who were aged <40 years, non-Hispanic, and practicing in the West or Midwest, and less often by obstetrician-gynecologists and private practice physicians. Concordant screening was facilitated by beliefs that updated guidelines were evidence-based and reduced harms, health care system dissemination of guidelines, and electronic medical record prompts. Barriers to concordant screening included using outdated guidelines, relying on personal judgment, concern about missing cancers, inappropriate patient risk assessment, and lack of support for guideline adoption through health care systems or electronic medical records. CONCLUSIONS Most clinicians screened with Pap/HPV cotesting and approximately one-half endorsed a 5-year screening interval. Clinician knowledge gaps include understanding the evidence underlying 5-year intervals and appropriate risk assessment to determine which patients should be screened more frequently. Education and tracking systems can promote guideline-concordant screening.
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Affiliation(s)
- Rebecca B Perkins
- Boston University, Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, Massachusetts.
| | - Lindsay Fuzzell
- H. Lee Moffitt Cancer Center & Research Institute, Health Outcomes and Behavior, Office of Community Outreach, Engagement, and Equity, Tampa, Florida
| | - Paige Lake
- H. Lee Moffitt Cancer Center & Research Institute, Health Outcomes and Behavior, Office of Community Outreach, Engagement, and Equity, Tampa, Florida
| | - Naomi C Brownstein
- Medical University of South Carolina, Public Health Sciences, Charleston, South Carolina
| | | | | | - Ashley Whitmer
- Boston University, Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, Massachusetts
| | - Susan T Vadaparampil
- H. Lee Moffitt Cancer Center & Research Institute, Health Outcomes and Behavior, Office of Community Outreach, Engagement, and Equity, Tampa, Florida
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Glauberman G, Mendoza Kabua P, Camba M, Dela Cruz M, Fontenot HB. Perspectives on Emergency Preparedness Among Indigenous Pacific People in Hawaii: A Qualitative Study. J Community Health Nurs 2024:1-14. [PMID: 38334130 DOI: 10.1080/07370016.2024.2309375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
PURPOSE This study sought an improved understanding of household emergency preparedness (EP) among Native Hawaiian, Pacific Islander, and Filipino (Indigenous Pacific People [IPP]) parents in Hawaii. DESIGN We conducted an exploratory qualitative descriptive study with 60-minute interviews occurring from October 2022 through March 2023. A semi-structured interview guide exploring participant household EP was employed. METHODS Prospective participants were females who identified as IPP, caregivers of a 0-12-year-old child, spoke English, and received health services at a federally qualified health center clinic. Two researchers conducted qualitative content analysis on interview transcripts. Initial coding of transcripts identified broad categories or themes. The process was reviewed continuously to verify data and coding procedures. Three investigators independently verified final themes and subthemes. FINDINGS Participants (N=25) were female, between 30-49 years of age (68%), had received some college education (60%), and were fully employed (68%). Major themes included: 1) Perceptions of family EP and current behaviors, 2) Barriers and challenges to family EP, and 3) Perspectives on strategies to improve family EP. Subthemes included risk perception for emergencies; family EP practices; health protection and pandemic preparedness; lack of knowledge and experience; social, cultural and economic barriers; and clinic-based, technology-driven, and community-based interventions. CONCLUSION Factors impeding access to healthcare services also impede family EP among IPP groups and their ability to mitigate the impact of future public health emergencies. CLINICAL EVIDENCE Targeted, innovative interventions, including ones led by health clinics and those that utilize technology, are needed to overcome common barriers faced and to facilitate the uptake of household EP behaviors among IPP families.
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Affiliation(s)
- Gary Glauberman
- University of Hawaii at Manoa School of Nursing, Honolulu, Hawaii, USA
| | | | | | | | - Holly B Fontenot
- University of Hawaii at Manoa School of Nursing, Honolulu, Hawaii, USA
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Lake P, Fuzzell L, Brownstein NC, Fontenot HB, Michel A, McIntyre M, Whitmer A, Rossi SL, Perkins RB, Vadaparampil ST. HPV vaccine recommendations by age: A survey of providers in federally qualified health centers. Hum Vaccin Immunother 2023; 19:2181610. [PMID: 36882951 PMCID: PMC10054304 DOI: 10.1080/21645515.2023.2181610] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Clinician recommendation remains a critical factor in improving HPV vaccine uptake. Clinicians practicing in federally qualified health centers were surveyed between October 2021 and July 2022. Clinicians were asked how they recommended HPV vaccination for patients aged 9-10, 11-12, 13-18, 19-26, and 27-45 y (strongly recommend, offer but do not recommend strongly, discuss only if the patient initiates the conversation, or recommend against). Descriptive statistics were assessed, and exact binomial logistic regression analyses were utilized to examine factors associated with HPV vaccination recommendation in 9-10-y-old patients. Respondents (n = 148) were primarily female (85%), between the ages of 30-39 (38%), white, non-Hispanic (62%), advanced practice providers (55%), family medicine specialty (70%), and practicing in the Northeast (63%). Strong recommendations for HPV vaccination varied by age: 65% strongly recommended for ages 9-10, 94% for ages 11-12, 96% for ages 13-18, 82% for age 19-26, and 26% for ages 27-45 y. Compared to Women's Health/OBGYN specialty, family medicine clinicians were less likely to recommend HPV vaccination at ages 9-10 (p = .03). Approximately two-thirds of clinicians practicing in federally qualified health centers or safety net settings strongly recommend HPV vaccine series initiation at ages 9-10. Additional research is needed to improve recommendations in younger age groups.
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Affiliation(s)
- Paige Lake
- Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Lindsay Fuzzell
- Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Naomi C Brownstein
- Office of Community Outreach, Engagement, and Equity, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
- Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Holly B Fontenot
- Nancy Atmospera-Walch School of Nursing, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Alexandra Michel
- Nancy Atmospera-Walch School of Nursing, University of Hawaii at Manoa, Honolulu, HI, USA
| | - McKenzie McIntyre
- Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Ashley Whitmer
- Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Sarah L Rossi
- Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston University, Boston, MA, USA
| | - Rebecca B Perkins
- Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston University, Boston, MA, USA
| | - Susan T Vadaparampil
- Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
- Office of Community Outreach, Engagement, and Equity, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
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Kostareva U, Soo Hoo CA, Zeng SM, Albright CL, Ceria-Ulep CD, Fontenot HB. Understanding Professional Medical Interpreters' Perspectives on Advancing Accurate and Culturally Informed Patient-Provider Communication for Filipinos in Hawai'i: Qualitative Analysis. Int J Environ Res Public Health 2023; 20:7012. [PMID: 37947568 PMCID: PMC10649552 DOI: 10.3390/ijerph20217012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/27/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023]
Abstract
One in every eight persons in Hawai'i, USA, have limited English proficiency (LEP) and are entitled to free language assistance for federally funded services under Title IV of the Civil Rights Act of 1964. They also have the right to culturally and linguistically appropriate services (CLAS) provided by professional medical interpreters (PMIs). This study's goals were to uncover barriers and facilitators of CLAS from the perspective of PMIs. PMIs for Filipino languages (n = 10) participated in an online survey and semi-structured interviews. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using conventional content analysis. Six themes emerged in the qualitative analysis: (1) cultural and social factors that can influence patient-provider communication; (2) barriers to effective patient-provider communication: patient, healthcare provider, and PMI levels; (3) facilitators of effective patient-provider communication: patient, healthcare provider, and PMI levels; (4) COVID-19 and remote interpreting barriers and facilitators; (5) strengths and weaknesses of in-person and stand-by interpreting appointments; and, (6) recommendations: system and provider levels. Proposed interventions could include advertising language services among Filipino communities and educating them about their language rights, providing additional resources for language assistance, employing more PMIs, training staff/providers, and supporting the use of PMIs versus untrained individuals.
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Affiliation(s)
- Uliana Kostareva
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Carrie A. Soo Hoo
- School of Education, Victoria University of Wellington, Kelburn, Wellington 6012, New Zealand
| | - Suzanne M. Zeng
- Language Services Hawaii, 3747A Waialae Avenue, Honolulu, HI 96816, USA
| | - Cheryl L. Albright
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Clementina D. Ceria-Ulep
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Holly B. Fontenot
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
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Bustamante G, Liebermann E, McNair K, Fontenot HB. Women's perceptions and preferences for cervical cancer screening in light of updated guidelines. J Am Assoc Nurse Pract 2023; 35:699-707. [PMID: 37498967 DOI: 10.1097/jxx.0000000000000923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/13/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Updated risk-based guidelines for cervical cancer screening (CCS) allow for individualized screening that minimizes unnecessary testing. However, these guidelines are complex and may not be easily understandable to patients. PURPOSE To describe women's perceptions and preferences about CCS in light of recent guideline changes. METHODOLOGY This qualitative study conducted in February 2020 used online, text-based focus groups with a sample of US women ( n = 49) ages 27-45. After participants completed a short demographic survey, an experienced moderator used a semistructured guide to solicit participants' perceptions of routine gynecologic care and CCS. We summarized survey data using descriptive statistics. Two authors analyzed transcripts using conventional content analysis and met with other team members to resolve discrepancies and determine final themes. RESULTS Most participants were non-Hispanic White (65%), had health insurance (90%), and reported having a routine gynecologic examination in the past year (70%). We identified four common themes: (1) low perceived risk of human papillomavirus (HPV) coupled with low knowledge about HPV as a causative factor for cervical cancer, (2) confusion about-and mistrust of-recent individual risk-based guidelines that determine the indicated timing and type of CCS test (Pap or HPV testing), (3) mixed opinions about performing a self-swab for HPV testing, and (4) conflicting perceptions of trust toward providers and the health care industry. CONCLUSIONS Findings highlight women's uncertainty and hesitancy about updated CCS guidelines. IMPLICATIONS Provider-patient communication strategies should consider women's gaps in knowledge about HPV, include the rationale for guidelines and types of tests, and build trust between patients and providers.
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Affiliation(s)
- Gabriela Bustamante
- Instituto de Medicina Social & Desafíos Globales, School of Public Health, Universidad San Francisco de Quito, Quito, Ecuador. Dr. Bustamante is previously at the Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Erica Liebermann
- College of Nursing, University of Rhode Island, Providence, Rhode Island
| | - Katelyn McNair
- Beth Israel Deaconess Lahey Health Breast Center, Plymouth, Massachusetts. Dr. McNair is previously at the Boston College, Connell School of Nursing, Chestnut Hill, Massachusetts
| | - Holly B Fontenot
- School of Nursing, University of Hawaii, Honolulu, Hawaii. Dr. Fontenot is previously at the Boston College, Connell School of Nursing, Chestnut Hill, Massachusetts
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Hale FB, Fontenot HB, Davis JW, Albright CL. Mental Illness as a Predictor of Subjective Happiness Among University Employees Working in Hawai'i. J Psychosoc Nurs Ment Health Serv 2023:1-10. [PMID: 37879086 DOI: 10.3928/02793695-20231017-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
The World Health Organization adopted happiness as an indicator of societal progress in addressing conditions that directly affect psychological well-being and recommended communities address the determinants and obstacles to subjective well-being. Therefore, we conducted an online survey, informed by the Sustainable Happiness Model, among university employees that measured life circumstances (sociodemographics) and intentional leisure-time moderate-to-vigorous physical activity as potential predictors of subjective happiness (assessed using the Subjective Happiness Scale [SHS]). The multiethnic sample (N = 85) primarily included those who identified as White (44%), Asian (33%), and Native Hawaiian and other Pacific Islander (16%). The most prevalent age range was 41 to 50 years (31%), and 55% of the sample identified as female, 78% as faculty, and 22% as staff. Reporting a current mental health condition had significantly lower SHS scores compared to all other factors. Future research should explore interventions to support and improve university employee's mental health and overall well-being. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].
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Fuzzell L, Lake P, Brownstein NC, Fontenot HB, Whitmer A, Michel A, McIntyre M, Rossi SL, Kajtezovic S, Vadaparampil ST, Perkins R. Examining the perceived impact of the COVID-19 pandemic on cervical cancer screening practices among clinicians practicing in Federally Qualified Health Centers: A mixed methods study. eLife 2023; 12:e86358. [PMID: 37664989 PMCID: PMC10476963 DOI: 10.7554/elife.86358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 07/28/2023] [Indexed: 09/05/2023] Open
Abstract
Background The COVID-19 pandemic led to reductions in cervical cancer screening and colposcopy. Therefore, in this mixed methods study we explored perceived pandemic-related practice changes to cervical cancer screenings in federally qualified health centers (FQHCs). Methods Between October 2021 and June 2022, we conducted a national web survey of clinicians (physicians and advanced practice providers) who performed cervical cancer screening in FQHCs in the United States during the post-acute phase of the COVID-19 pandemic, along with a sub-set of qualitative interviews via video conference, to examine perceived changes in cervical cancer screening practices during the pandemic. Results A total of 148 clinicians completed surveys; a subset (n=13) completed qualitative interviews. Most (86%) reported reduced cervical cancer screening early in the pandemic, and 28% reported continued reduction in services at the time of survey completion (October 2021- July 2022). Nearly half (45%) reported staff shortages impacting their ability to screen or track patients. Compared to clinicians in Obstetrics/Gynecology/Women's health, those in family medicine and other specialties more often reported reduced screening compared to pre-pandemic. Most (92%) felt that screening using HPV self-sampling would be very or somewhat helpful to address screening backlogs. Qualitative interviews highlighted the impacts of staff shortages and strategies for improvement. Conclusions Findings highlight that in late 2021 and early 2022, many clinicians in FQHCs reported reduced cervical cancer screening and of pandemic-related staffing shortages impacting screening and follow-up. If not addressed, reduced screenings among underserved populations could worsen cervical cancer disparities in the future. Funding This study was funded by the American Cancer Society, who had no role in the study's design, conduct, or reporting.
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Affiliation(s)
- Lindsay Fuzzell
- H. Lee Moffitt Cancer Center & Research Institute, Health Outcomes and BehaviorTampaUnited States
| | - Paige Lake
- H. Lee Moffitt Cancer Center & Research Institute, Health Outcomes and BehaviorTampaUnited States
| | - Naomi C Brownstein
- Medical University of South Carolina, Public Health SciencesCharlestonUnited States
| | - Holly B Fontenot
- University of Hawaii at Manoa, Nancy Atmospera-Walch School of NursingHonoluluUnited States
| | - Ashley Whitmer
- H. Lee Moffitt Cancer Center & Research Institute, Health Outcomes and BehaviorTampaUnited States
| | - Alexandra Michel
- University of Hawaii at Manoa, Nancy Atmospera-Walch School of NursingHonoluluUnited States
| | - McKenzie McIntyre
- H. Lee Moffitt Cancer Center & Research Institute, Health Outcomes and BehaviorTampaUnited States
| | - Sarah L Rossi
- Boston University, Chobanian & Avedisian School of MedicineBostonUnited States
| | - Sidika Kajtezovic
- Boston University, Chobanian & Avedisian School of MedicineBostonUnited States
| | - Susan T Vadaparampil
- H. Lee Moffitt Cancer Center & Research Institute, Health Outcomes and BehaviorTampaUnited States
- H. Lee Moffitt Cancer Center & Research Institute, Office of Community Outreach, Engagement, and EquityTampaUnited States
| | - Rebecca Perkins
- Boston University, Chobanian & Avedisian School of MedicineBostonUnited States
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Vadaparampil ST, Fuzzell LN, Brownstein NC, Fontenot HB, Lake P, Michel A, McIntyre M, Whitmer A, Perkins RB. A cross-sectional survey examining clinician characteristics, practices, and attitudes associated with adoption of the 2019 American Society for Colposcopy and Cervical Pathology risk-based management consensus guidelines. Cancer 2023; 129:2671-2684. [PMID: 37221653 DOI: 10.1002/cncr.34838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND The 2019 American Society for Colposcopy and Cervical Pathology (ASCCP) risk-based management consensus guidelines are the most recent national guidelines for the management of abnormal cervical cancer screening tests. These guidelines benefit patients by concentrating testing and treatment in those at highest cervical cancer risk. Adoption of guidelines often occurs slowly, with few studies examining the factors associated with guideline-adherent management of abnormal results. METHODS To elucidate the factors associated with the use of the 2019 ASCCP guidelines among clinicians who perform cervical cancer screening, physicians and advanced practice professionals who perform cervical cancer screening were cross-sectionally surveyed. Clinicians responded to screening vignettes with differing recommendations for management between the 2019 and prior management guidelines. Screening vignette 1 involved reduction of invasive testing on a low-risk patient; screening vignette 2 involved increased surveillance testing on a high-risk patient. Binomial logistic regression models determined the factors associated with the use of the 2019 guidelines. RESULTS A total of 1251 clinicians participated from across the United States. For screening vignettes 1 and 2, guideline-adherent responses were given by 28% and 36% of participants, respectively. Management recommendations differed by specialty and were incorrect in different situations: there was inappropriate invasive testing by obstetrics and gynecology physicians (vignette 1) and inappropriate discontinuation of screening by family and internal medicine physicians (vignette 2). Regardless of their chosen response, over half erroneously believed they were guideline adherent. CONCLUSIONS Many clinicians who believe they are following appropriate guidelines may not realize their management strategy is inconsistent with the 2019 guidelines. Education initiatives tailored to clinician specialty could address the understanding of current guidelines, encourage the use of updated guidelines, maximize patient benefits, and minimize harms. PLAIN LANGUAGE SUMMARY The 2019 American Society for Colposcopy and Cervical Pathology risk-based management consensus guidelines are the most recent national guidelines for abnormal cervical cancer screening test management. We surveyed over 1200 obstetrics and gynecology (OB/GYN), family medicine, and internal medicine physicians and advanced practice providers about their screening and abnormal results follow-up practices in relation to guidelines. Few clinicians are following the 2019 guidelines. Management recommendations differed by clinician specialty and were incorrect in different situations: there was inappropriate invasive testing by OB/GYN physicians and inappropriate screening discontinuation by family and internal medicine physicians. Education tailored by clinician specialty could address the understanding of current guidelines, encourage the use of updated guidelines, maximize patient benefits, and minimize harms.
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Affiliation(s)
- Susan T Vadaparampil
- Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Office of Community Outreach, Engagement, and Equity, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Lindsay N Fuzzell
- Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Naomi C Brownstein
- Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Holly B Fontenot
- Nancy Atmospera-Walch School of Nursing, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Paige Lake
- Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Alexandra Michel
- Nancy Atmospera-Walch School of Nursing, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - McKenzie McIntyre
- Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Ashley Whitmer
- Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Rebecca B Perkins
- Chobanian & Avedisian School of Medicine, Boston University, Boston, Massachusetts, USA
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12
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Liebermann E, Fontenot HB, Lim E, Matsunaga M, Zimet G, Allen JD. Preferred Location for Human Papillomavirus Self-Sampling for Cervical Cancer Screening. J Obstet Gynecol Neonatal Nurs 2023; 52:364-373. [PMID: 37355248 DOI: 10.1016/j.jogn.2023.05.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/24/2023] [Accepted: 05/24/2023] [Indexed: 06/26/2023] Open
Abstract
OBJECTIVE To examine associations among women's preferred locations for human papillomavirus (HPV) self-sampling in relation to their demographic, social, and health characteristics and their perceived benefits and concerns regarding this procedure. DESIGN Cross-sectional, descriptive survey. SETTING Online distribution between March 2022 and April 2022. PARTICIPANTS People who were assigned female sex at birth and were eligible for cervical cancer screening (N = 367: cis-gender women, n = 364; another gender identity, n = 3). METHODS We used quota sampling to obtain a racially and ethnically diverse sample. We conducted bivariate analyses to examine differences in participants' preferred locations for HPV self-sampling by sociodemographic and health characteristics. We used a multinomial logistic regression model to examine the associations between preferred HPV self-sampling location, characteristics of participants, and perceived benefits and concerns regarding this procedure. RESULTS In our sample, 43% (n = 158) of participants preferred HPV self-sampling at the office of a health care provider, 50% (n = 182) preferred HPV self-sampling anywhere (office or home), and 7% (n = 27) did not feel comfortable with HPV self-sampling anywhere. Participants 39 to 45 years of age were more likely to prefer HPV self-sampling anywhere (office or home) than participants 27 to 32 years of age, OR = 2.47, 95% confidence interval (CI) [1.21, 5.06]. Participants who preferred HPV self-sampling anywhere perceived greater benefit related to limited geographic access to a clinic compared to those who preferred office only, OR = 1.82, 95% CI [1.08, 3.07]. Participants who preferred HPV self-sampling anywhere had less concern related to performing the procedure accurately than those who preferred office only, OR = 0.44, 95% CI [0.31, 0.62]. CONCLUSION HPV self-sampling is an alternative strategy to increase cervical cancer screening. As providers consider implementation of HPV self-sampling, our findings suggest that office and home-based collection strategies should be considered to increase access to cervical cancer screening.
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13
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Fuzzell L, Brownstein NC, Fontenot HB, Lake PW, Michel A, Whitmer A, Rossi SL, McIntyre M, Vadaparampil ST, Perkins RB. Examining the association of clinician characteristics with perceived changes in cervical cancer screening and colposcopy practice during the COVID-19 pandemic: a mixed methods assessment. eLife 2023; 12:e85682. [PMID: 37656169 PMCID: PMC10473834 DOI: 10.7554/elife.85682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 08/07/2023] [Indexed: 09/02/2023] Open
Abstract
Background The COVID-19 pandemic led to reductions in cervical cancer screening and colposcopy. Therefore, in this mixed method study we explored perceived pandemic-related practice changes to cervical cancer screenings and colposcopies. Methods In 2021, a national sample of 1251 clinicians completed surveys, including 675 clinicians who performed colposcopy; a subset (n=55) of clinicians completed qualitative interviews. Results Nearly half of all clinicians reported they were currently performing fewer cervical cancer screenings (47%) and colposcopies (44% of those who perform the procedure) than before the pandemic. About one-fifth (18.6%) of colposcopists reported performing fewer LEEPs than prior to the pandemic. Binomial regression analyses indicated that older, as well as internal medicine and family medicine clinicians (compared to OB-GYNs), and those practicing in community health centers (compared to private practice) had higher odds of reporting reduced screening. Among colposcopists, internal medicine physicians and those practicing in community health centers had higher odds of reporting reduced colposcopies. Qualitative interviews highlighted pandemic-related care disruptions and lack of tracking systems to identify overdue screenings. Conclusions Reductions in cervical cancer screening and colposcopy among nearly half of clinicians more than 1 year into the pandemic raise concerns that inadequate screening and follow-up will lead to future increases in preventable cancers. Funding This study was funded by the American Cancer Society, who had no role in the study's design, conduct, or reporting.
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Affiliation(s)
- Lindsay Fuzzell
- H. Lee Moffitt Cancer Center & Research Institute, Health Outcomes and BehaviorTampaUnited States
| | | | - Holly B Fontenot
- University of Hawaii at Manoa, Nancy Atmospera-Walch School of NursingHonoluluUnited States
| | - Paige W Lake
- H. Lee Moffitt Cancer Center & Research Institute, Health Outcomes and BehaviorTampaUnited States
| | - Alexandra Michel
- University of Hawaii at Manoa, Nancy Atmospera-Walch School of NursingHonoluluUnited States
| | - Ashley Whitmer
- H. Lee Moffitt Cancer Center & Research Institute, Health Outcomes and BehaviorTampaUnited States
| | - Sarah L Rossi
- Boston University, Chobanian & Avedisian School of MedicineBostonUnited States
| | - McKenzie McIntyre
- H. Lee Moffitt Cancer Center & Research Institute, Health Outcomes and BehaviorTampaUnited States
| | - Susan T Vadaparampil
- H. Lee Moffitt Cancer Center & Research Institute, Health Outcomes and BehaviorTampaUnited States
- H. Lee Moffitt Cancer Center & Research Institute, Office of Community Outreach, Engagement, and EquityTampaUnited States
| | - Rebecca B Perkins
- Boston University, Chobanian & Avedisian School of MedicineBostonUnited States
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14
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Glauberman G, Zimet G, Michel A, Fontenot HB. Emergency preparedness is a healthcare issue: COVID-19 pandemic's influence on attitudes and behaviors among a national sample of parents. J Pediatr Nurs 2023; 71:88-94. [PMID: 37080118 PMCID: PMC10090324 DOI: 10.1016/j.pedn.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/07/2023] [Accepted: 04/10/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Improving household emergency preparedness (EP) is a public health priority, yet little is known about what influence the COVID-19 pandemic had on families' EP. This study aimed to explore current EP attitudes and behaviors. METHODS We conducted online focus groups in Winter 2022 with a nationwide sample of parents of adolescents. We held six 90-min focus groups of 9-15 participants using a semi-structured interview script that elicited parental knowledge and attitudes related to household EP. Two researchers conducted qualitative content analysis on focus group transcripts. First-level coding within and across scripts was used to identify broad categories or themes regarding EP. The process was reviewed continuously to verify data and coding procedures. Three investigators independently verified the final themes that emerged. RESULTS Participants (N = 64) were mostly female (n = 54, 84.3%), white (n = 46, 71.9%), and college-educated (n = 49, 76.6%). Major themes included: 1) Expanded awareness and behavioral change related to EP due to the COVID-19 pandemic, 2) Reconceptualization of planning for family health as part of EP, 3) Changing perspectives related to vaccination as a component of EP, and 4) Perspectives related to discussing EP with their health care provider. CONCLUSIONS EP was described as a healthcare issue and healthcare providers were identified as trusted sources of EP information. Interventions to support providers' ability to assist with individual EP health action plans, including discussing vaccination as part of preparedness are needed.
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Affiliation(s)
- Gary Glauberman
- University of Hawaii at Manoa, School of Nursing & Dental Hygiene, 2528 McCarthy Mall, Webster Hall, Honolulu, HI 96822, USA.
| | - Gregory Zimet
- Indiana University School of Medicine, Department of Pediatrics, Indianapolis, IN 46202, USA.
| | - Alexandra Michel
- University of Hawaii at Manoa, School of Nursing & Dental Hygiene, 2528 McCarthy Mall, Webster Hall, Honolulu, HI 96822, USA.
| | - Holly B Fontenot
- University of Hawaii at Manoa, School of Nursing & Dental Hygiene, 2528 McCarthy Mall, Webster Hall, Honolulu, HI 96822, USA.
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15
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Allen JD, Matsunaga M, Lim E, Zimet GD, Nguyen KH, Fontenot HB. Parental Decision Making Regarding COVID-19 Vaccines for Children under Age 5: Does Decision Self-Efficacy Play a Role? Vaccines (Basel) 2023; 11:478. [PMID: 36851355 PMCID: PMC9959902 DOI: 10.3390/vaccines11020478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/31/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND COVID-19 vaccines are now available under Emergency Use Authorization for children ages 6 months to 5 years. We examined parents' intentions to vaccinate their children under the age of 5 years and assessed whether their confidence in making an informed decision about vaccination (decision self-efficacy) was associated with these intentions. METHOD We conducted a cross-sectional online survey of U.S. parents between 23 March and 5 April 2022. We examined associations between parental intention to vaccinate their young children ( RESULTS Of the 591 parents in this sample, 49% indicated that they intended to vaccinate their child(ren), 29% reported that they would not, and 21% were undecided. In bivariate analyses, race/ethnicity, health insurance, flu vaccination in the past 12 months, and parental COVID-19 vaccination status were significantly related to parental intention to vaccinate their child(ren). In the multivariable analyses, which controlled for these factors, parents who intended to vaccinate their child(ren) had greater confidence in their ability to make informed decisions about COVID-19 vaccinations compared to those who were unsure about vaccination. Each one standard deviation in the Decision Self-Efficacy score was associated with a 39% increase in intention to vaccinate one's child versus being unsure about vaccination (AOR 1.39, 95% CI 1.09, 1.77). CONCLUSIONS Parents who are unsure about vaccinating their children against COVID-19 may benefit from interventions designed to increase their ability to obtain, understand, and utilize information to make informed decisions.
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Affiliation(s)
- Jennifer D. Allen
- Department of Community Health, Tufts University School of Arts and Sciences, 574 Boston Ave, Medford, MA 02155, USA
| | - Masako Matsunaga
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA
| | - Eunjung Lim
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA
| | - Gregory D. Zimet
- Department of Pediatrics, Indiana University School of Medicine, 410 West 10th Street, Suite 1001, Indianapolis, IN 46202, USA
| | - Kimberly H. Nguyen
- Department of Public Health and Community Medicine, Tufts University Medical School, 136 Harrison Ave, Boston, MA 02111, USA
| | - Holly B. Fontenot
- Nancy Atmospera-Walch School of Nursing, University of Hawaii at Manoa, 2528 McCarthy Mall, Webster Hall, Honolulu, HI 96822, USA
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16
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Geffen SR, Wang T, Cahill S, Fontenot HB, Conron K, Wilson JM, Avripas SA, Michaels S, Johns MM, Dunville R. Recruiting, Facilitating, and Retaining a Youth Community Advisory Board to Inform an HIV Prevention Research Project with Sexual and Gender Minority Youth. LGBT Health 2023; 10:93-98. [PMID: 36637887 DOI: 10.1089/lgbt.2022.0213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Sexual and gender minority (SGM) youth are at disproportionate risk of acquiring HIV, and as such, SGM youth should be meaningfully engaged in research aimed at developing effective, tailored HIV interventions. Youth Community Advisory Boards (YCABs) are an important element of community-engaged research and support the development of community-informed interventions. This article describes recruitment, facilitation, and retention of a YCAB composed of SGM youth in Greater Boston, to inform a national HIV prevention research project. These lessons can serve as a guide to future researchers who want to form YCABs as part of community-engaged research.
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Affiliation(s)
- Sophia R Geffen
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Timothy Wang
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Sean Cahill
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA.,Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts, USA.,Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Kerith Conron
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA.,The Williams Institute, UCLA School of Law, Los Angeles, California, USA
| | | | | | | | - Michelle M Johns
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Richard Dunville
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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17
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Mattheus D, Fontenot HB, Lim E, Owens M, Wong L. Increasing the Self-Confidence of School Nurses to Respond to Emergency Situations. J Contin Educ Nurs 2023; 54:71-77. [PMID: 36720099 DOI: 10.3928/00220124-20230113-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND School nurses have various degrees of experience responding to respiratory or cardiac emergencies, and most only receive Basic Life Support training every 2 years as required. The goal of the study was to assess school nurses' confidence and competence in emergency situations before and after engaging in emergency preparedness high-fidelity simulations. METHOD This mixed methods study used a pre-/postsimulation survey design for a group of school nurses (N = 40) in the State of Hawaii. The pre- and postsimulation survey assessed professional demographics and measured confidence. After the presimulation survey, nurses participated in a 1-day training that included two separate emergency simulations using high-fidelity equipment. In addition, education was provided on the program's standardized emergency supply bags with equipment and their use during an emergency. The postsimulation survey was distributed 5 days after the educational intervention. RESULTS All confidence items significantly improved after the simulation session. Nurses noted the value of the training and hands-on simulation experience. CONCLUSION Simulation is a useful tool for increasing school nurses' confidence in responding to emergencies occurring on school campuses. [J Contin Educ Nurs. 2023;54(2):71-77.].
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18
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Hale FB, Mattheus D, Fletcher B, Michel A, Fontenot HB. Effects of the COVID 19 Pandemic on School Nurses' Resiliency and Ability to Cope: A Mixed Methods Study in the State of Hawaii. J Sch Nurs 2022; 39:133-142. [PMID: 36128780 PMCID: PMC9494163 DOI: 10.1177/10598405221124423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
This mixed-method study examined school nurses' experiences during the Coronavirus Disease 2019 pandemic related to role change, psychological feelings, and coping/resiliency in the State of Hawaii. A total of 30 school nurses completed a Brief Resilience Coping Scale plus a series of open-ended questions in January 2022. On the coping scale, over 40% of participants scored high, 52% scored medium, and 7% scored a low resilient/coping level. We did not identify any association between coping level and participant characteristics. Three qualitative themes emerged: 1) school nurses experience chronic negative emotions related to the pandemic, 2) school nurses demonstrate attributes of resilience, and 3) school nurses utilize positive coping techniques. The pandemic created significant stresses and negative emotions among school nurses. Yet, school nurses reported effective coping strategies and demonstrated strength/resilience. Support and open communication between school nurses, their employers, and other school-based stakeholders is needed to provide continued support for school nurses.
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Affiliation(s)
- Frankie B. Hale
- University of Hawaii at
Manoa, Nancy Atmospera-Walch School of Nursing, Honolulu, HI,
USA,Frankie B. Hale, PhD, RN, University of
Hawaii at Manoa, Nancy Amosphera-Walch School of Nursing; 2528 McCarthy Mall,
Webster Hall 215, Honolulu, HI 96822, USA.
| | - Deborah Mattheus
- University of Hawaii at
Manoa, Nancy Atmospera-Walch School of Nursing, Honolulu, HI,
USA,University of Hawaii at
Manoa, Hawaii Keiki Program, Honolulu, HI, USA
| | - Betty Fletcher
- University of Hawaii at
Manoa, Hawaii Keiki Program, Honolulu, HI, USA
| | - Alexandra Michel
- University of Hawaii at
Manoa, Nancy Atmospera-Walch School of Nursing, Honolulu, HI,
USA
| | - Holly B. Fontenot
- University of Hawaii at
Manoa, Nancy Atmospera-Walch School of Nursing, Honolulu, HI,
USA
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19
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White BP, Abuelezam NN, Fontenot HB, Jurgens CY. Exploring Relationships Between State-Level LGBTQ Inclusivity and BRFSS Indicators of Mental Health and Risk Behaviors: A Secondary Analysis. J Am Psychiatr Nurses Assoc 2022; 29:224-231. [PMID: 36113408 DOI: 10.1177/10783903211007900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Minority Stress Theory suggests that repeated exposure to enacted stigma adversely affects mental health. States have wide authority to enact policies affecting the level of inclusivity experienced by lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) residents. The purpose of this study was to explore relationships between states' level of LGBTQ inclusivity and indicators of mental health/risk behaviors among an LGBTQ sample. METHODS The 2018 Human Rights Campaign State Equality Index (SEI) and the 2018 Behavioral Risk Factor Surveillance Survey (BRFSS) were used to examine relationships between states' levels of LGBTQ inclusivity (predictor variable) and indicators of mental health/risk behaviors (outcome variables). Relationships were explored using descriptive statistics and survey-weighted logistic regression. RESULTS Lower state inclusivity increased odds of fair/poor general health (adjusted odds ratio [AOR]: 1.22, 95% confidence interval [CI]: 1.01-1.48), increased odds of poor mental health days (AOR: 1.34, 95% CI: 1.11-1.62), increased odds of smoking (AOR: 1.62, 95% CI: 1.27-2.07), and increased odds of heavy drinking (AOR: 1.54, 95% CI: 1.26-1.86) and binge drinking (AOR: 1.23, 95% CI: 1.01-1.49). State inclusivity did not influence odds of a depressive disorder diagnosis or driving under the influence of alcohol. CONCLUSIONS LGBTQ persons in restrictive states had increased odds of experiencing several indicators of mental health and risk behaviors. More research is needed to determine whether state policies affect other domains of LGBTQ persons' health. Health care providers should be mindful of LGBTQ persons' mental health/risk behaviors and the state policy environment, and should seek to implement mitigating health care strategies such as the use of validated assessment.
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Affiliation(s)
| | | | - Holly B Fontenot
- Holly B. Fontenot, PhD, APRN, WHNP-BC, FAAN, FNAP, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Corrine Y Jurgens
- Corrine Y. Jurgens, PhD, RN, ANP, FAHA, FHFSA, FAAN, Boston College, Chestnut Hill, MA, USA
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20
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White LS, Maulucci E, Kornides M, Aryal S, Alix C, Sneider D, Gagnon J, Winfield EC, Fontenot HB. HPV Vaccination Rates of 7 th Grade Students After a Strong Recommending Statement from the School Nurse. J Sch Nurs 2022:10598405221118824. [PMID: 35942704 DOI: 10.1177/10598405221118824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The Human Papillomavirus (HPV) vaccine can prevent 90% of cancers caused by HPV. Health care provider recommendations affect vaccine uptake, yet there are a lack of studies examining the impact of the school nurse (SN) in vaccine recommendations. The purpose of this study was to evaluate the impact of adding a SN HPV recommendation to the standard vaccination letter sent to parents/guardians. The rate of vaccination between the intervention and control schools was not statistically significant (Estimate (Std. Error) = -0.3066 (0.2151), p = 0.154). After controlling for age, sex, race, insurance type, and medical practice type, there was no significant difference in the likelihood to receive the HPV vaccine (OR = 1.53, 95% CI: 0.563-4.19 in 2018; OR = 1.34, 95% CI: 0.124-14.54 in 2019. Further work is needed to clarify how school nurses can better promote HPV vaccine, and which adolescent demographic groups (e.g., race, insurance type, provider type) face barriers to HPV vaccine uptake.
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Affiliation(s)
| | - Emily Maulucci
- William F. Connell School of Nursing, 6019Boston College, Chestnut Hill, MA, USA
| | - Melanie Kornides
- William F. Connell School of Nursing, 6019Boston College, Chestnut Hill, MA, USA
| | - Subhash Aryal
- William F. Connell School of Nursing, 6019Boston College, Chestnut Hill, MA, USA
| | - Catherine Alix
- William F. Connell School of Nursing, 6019Boston College, Chestnut Hill, MA, USA
| | - Diane Sneider
- William F. Connell School of Nursing, 6019Boston College, Chestnut Hill, MA, USA
| | - Jessica Gagnon
- William F. Connell School of Nursing, 6019Boston College, Chestnut Hill, MA, USA
| | - Elizabeth C Winfield
- William F. Connell School of Nursing, 6019Boston College, Chestnut Hill, MA, USA
| | - Holly B Fontenot
- William F. Connell School of Nursing, 6019Boston College, Chestnut Hill, MA, USA
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21
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Sullivan C, Michel A, Fontenot HB, Minton L, Lee MJ, Bartholomew M. Patient Perceptions of a Model of Street Health Care in O’Ahu. J Obstet Gynecol Neonatal Nurs 2022. [DOI: 10.1016/j.jogn.2022.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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22
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Fontenot HB, Michel A, Lim E, Glauberman GH, Ryan N, Davis KF, Mattheus D. Impact of the COVID-19 Pandemic on the Hawai'i Nursing Workforce: A Cross-sectional Survey. Hawaii J Health Soc Welf 2022; 81:119-126. [PMID: 35528753 PMCID: PMC9077570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The coronavirus disease (COVID-19) pandemic has placed extraordinary strain on health care systems. This has led to increased stress among health care workers, and nurses in particular, which has had a negative impact on their physical and psychosocial wellbeing. This is likely to negatively impact the nursing workforce at the state and national levels as the pandemic continues. The purpose of this study was to assess whether nurses licensed in Hawai'i have considered leaving the workforce. A cross-sectional online survey was conducted among Hawai'i nurses at all levels of licensure, with 421 responding. Of these nurses, 97 (23.0%) reported considering leaving the workforce, with safety (39.2%) and family/caregiver strain (32.0%) being the most common reasons. Reconsidering whether they should stay employed in their current roles (Odds ratio [OR] 2.05; 95% CI 1.56 - 2.69) and fear to continue providing direct patient care (OR 1.97; 95% CI 1.54 - 2.54) were associated with increased odds of having considered leaving the workforce. Based on these results, the State of Hawai'i and local health care organizations need to adjust their nursing workforce estimates and address how to alleviate nurses' stressors and safety concerns to mitigate a potential workforce shortage. Research is needed to develop interventions to support and empower nurses in their current roles but also address future emergency preparedness.
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Affiliation(s)
- Holly B. Fontenot
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Manoa, Honolulu, HI (HBF, AM, GHRG, NR, KFD, DM)
| | - Alexandra Michel
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Manoa, Honolulu, HI (HBF, AM, GHRG, NR, KFD, DM)
| | - Eunjung Lim
- Department of Quantitative Health Science, John A. Burns School of Medicine, University of Hawai‘i at Manoa, Honolulu, HI (EL)
| | - Gary H.R. Glauberman
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Manoa, Honolulu, HI (HBF, AM, GHRG, NR, KFD, DM)
| | - Nicole Ryan
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Manoa, Honolulu, HI (HBF, AM, GHRG, NR, KFD, DM)
| | - Katherine Finn Davis
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Manoa, Honolulu, HI (HBF, AM, GHRG, NR, KFD, DM)
| | - Deborah Mattheus
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Manoa, Honolulu, HI (HBF, AM, GHRG, NR, KFD, DM)
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Fontenot HB, Mattheus DB, Lim E, Michel A, Ryan N, Knopf A, Abuelezam NN, Stamp K, Hekel B, Branson S, Zimet G. Undergraduate nursing students' COVID-19 vaccine intentions: A national survey. PLoS One 2021; 16:e0261669. [PMID: 34936687 PMCID: PMC8694464 DOI: 10.1371/journal.pone.0261669] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 12/08/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction In December 2020, the first two COVID-19 vaccines were approved in the United States (U.S.) and recommended for distribution to front-line personnel, including nurses. Nursing students are being prepared to fill critical gaps in the health care workforce and have played important supportive roles during the current pandemic. Research has focused on vaccine intentions of current health care providers and less is known about students’ intentions to vaccinate for COVID-19. Methods A national sample of undergraduate nursing students were recruited across five nursing schools in five U.S. regions in December 2020. The survey measured perceived risk/threat of COVID-19, COVID-19 vaccine attitudes, perceived safety and efficacy of COVID-19 vaccines, sources for vaccine information and level of intention to become vaccinated [primary, secondary (i.e., delayed), or no intention to vaccinate]. Results The final sample consisted of 772 students. The majority (83.6%) had intentions to be vaccinated, however of those 31.1% indicated secondary intention, a delay in intention or increased hesitancy). The strongest predictors of primary intention were positive attitudes (OR = 6.86; CI = 4.39–10.72), having lower safety concerns (OR = 0.26; CI = 0.18–0.36), and consulting social media as a source of information (OR = 1.56; CI = 1.23–1.97). Asian (OR = 0.47; CI = 0.23–0.97) and Black (OR 0.26; CI = 0.08–0.80) students were more likely to indicate secondary intention as compared to primary intention. Students in the Midwest were most likely to indicate no intention as compared to secondary intention (OR = 4.6; CI = 1.32–16.11). Conclusions As the first two COVID-19 vaccines were approved/recommended in the U.S. nursing students had overall high intentions to vaccinate. Findings can guide development of educational interventions that reduce concerns of vaccine safety that are delivered in a way that is supportive and affirming to minoritized populations while being respectful of geo-political differences.
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Affiliation(s)
- Holly B Fontenot
- School of Nursing & Dental Hygiene, University of Hawaii at Manoa, Honolulu, Hawaii, United States of America
| | - Deborah B Mattheus
- School of Nursing & Dental Hygiene, University of Hawaii at Manoa, Honolulu, Hawaii, United States of America
| | - Eunjung Lim
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, United States of America
| | - Alexandra Michel
- School of Nursing & Dental Hygiene, University of Hawaii at Manoa, Honolulu, Hawaii, United States of America
| | - Nicole Ryan
- School of Nursing & Dental Hygiene, University of Hawaii at Manoa, Honolulu, Hawaii, United States of America
| | - Amelia Knopf
- Department of Community and Health Services, School of Nursing, Indiana University, Indianapolis, Indiana, United States of America
| | - Nadia N Abuelezam
- Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, United States of America
| | - Kelly Stamp
- School of Nursing, University of North Carolina at Greensboro, Greensboro, North Carolina, United States of America
| | - Barbara Hekel
- Cizik School of Nursing, UTHealth, Houston, Texas, United States of America
| | - Sandra Branson
- Cizik School of Nursing, UTHealth, Houston, Texas, United States of America
| | - Gregory Zimet
- Division of Adolescent Medicine, School of Medicine, Indiana University, Indianapolis, Indiana, United States of America
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Cahill SR, Wang TM, Fontenot HB, Geffen SR, Conron KJ, Mayer KH, Johns MM, Avripas SA, Michaels S, Dunville R. Perspectives on Sexual Health, Sexual Health Education, and HIV Prevention From Adolescent (13-18 Years) Sexual Minority Males. J Pediatr Health Care 2021; 35:500-508. [PMID: 34154868 PMCID: PMC8419154 DOI: 10.1016/j.pedhc.2021.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/13/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Adolescent sexual minority males (ASMM) are at disproportionate risk of HIV infection. The purpose of this study was to assess ASMM's attitudes about sexual health, barriers/facilitators to accessing HIV prevention, and actual versus ideal interactions for receiving sexual health care and information. METHOD Two online and two in-person focus groups were conducted with ASMM from across the United States. Qualitative data were analyzed using content analysis. RESULTS Twenty-one racially diverse ASMM participated (average age = 16.4 years). Online focus groups were superior for reaching the target population. Four themes emerged: 1: identity formation and sources of support, 2: challenges to obtaining sexual health information, 3: attitudes/beliefs about sex and sexual behaviors, and 4: barriers to HIV prevention. DISCUSSION These findings illustrate current gaps in sexual health knowledge, as well as barriers and facilitators to obtaining sexual health information, sexual health care, and affirming education and support for ASMM.
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Affiliation(s)
- Sean R Cahill
- Sean R. Cahill, Director of Health Policy Research, The Fenway Institute, Fenway Health; Adjunct Associate Professor of the Practice, Department of Health Law, Policy and Management, Boston University School of Public Health; Affiliate Associate Clinical Professor and Visiting Scholar, Bouve College of Health Sciences, Northeastern University, Boston, MA.
| | - Timothy M Wang
- Timothy M. Wang, Director of Policy and Advocacy, Howard Brown Health Center, Chicago, IL
| | - Holly B Fontenot
- Holly B. Fontenot, Affiliated Faculty, The Fenway Institute, Fenway Health, Boston, MA and Associate Professor & Frances A. Matsuda Chair in Women's Health, School of Nursing & Dental Hygiene, University of Hawaii at Manoa, Honolulu, HI
| | - Sophia R Geffen
- Sophia R. Geffen, HIV Prevention Research Project Manager, The Fenway Institute, Fenway Health, Boston, MA
| | - Kerith J Conron
- Kerith Conron, Blachford-Cooper Research Director and Distinguished Scholar, The Williams Institute, UCLA School of Law, Los Angeles, CA
| | - Kenneth H Mayer
- Kenneth H. Mayer, Medical Research Director and Co-Director, The Fenway Institute, Fenway Health; Professor of Medicine, Harvard Medical School; Attending Physician, Division of Infectious Disease, Beth Israel Deaconess Medical Center, Boston, MA
| | - Michelle M Johns
- Michelle M. John, Health Scientist, Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sabrina A Avripas
- Sabrina A. Avripas, Senior Research Director, Public Health, NORC at the University of Chicago, Chicago, IL
| | - Stuart Michaels
- Stuart Michaels, Senior Research Scientist, Ogburn-Stouffer Center for the Study of Social Organizations, NORC at the University of Chicago, Chicago, IL
| | - Richard Dunville
- Richard Dunville, Deputy Director, Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
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25
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Fontenot HB, Mattheus D, Lim E, Michel A, Ryan N, Davis KF, Zimet G. Assessing licensed nurses COVID-19 vaccine attitudes and intentions: a cross-sectional survey in the state of Hawaii. Hum Vaccin Immunother 2021; 17:3933-3940. [PMID: 34254888 DOI: 10.1080/21645515.2021.1947097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Nurses are the largest single occupation of health care providers and at greatest risk for exposure to and acquisition of Coronavirus Disease 2019 (COVID-19). In December 2020, nurses in Hawaii were recruited for an online survey that measured perceived risk/threat of COVID-19, vaccine attitudes, and perceived safety of COVID-19 vaccines, as well as level of intention: primary, secondary (i.e., delayed), or no intention to vaccinate. The final sample consisted of 423 nurses. Participants were primarily Asian (27.9%) and White (45.2%). The majority were 18-50 years (65.5%) and female (87.0%), held an RN license (91.7%), and identified as a staff nurse (57.7%) in the hospital setting (56.7%). Among participants, 52.3% indicated primary intention, 27.9% secondary intention, and 19.9% no intention to vaccinate. The strongest predictors of any level of intention were greater positive attitudes toward COVID-19 vaccination and lower concerns related to COVID-19 vaccine safety. Findings can guide interventions to support vaccine acceptance for those who initially decline vaccination.
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Affiliation(s)
- Holly B Fontenot
- School of Nursing & Dental Hygiene, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Deborah Mattheus
- School of Nursing & Dental Hygiene, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Eunjung Lim
- John A. Burns School of Medicine, Department of Biostatistics, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Alexandra Michel
- School of Nursing & Dental Hygiene, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Nicole Ryan
- School of Nursing & Dental Hygiene, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Katherine Finn Davis
- School of Nursing & Dental Hygiene, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Gregory Zimet
- Division of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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26
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Thompson EL, Daley EM, Washburn T, Salisbury-Keith K, Saslow D, Fontenot HB, Zimet GD. School-entry requirements for HPV vaccination: part of the patchwork for HPV-related cancer prevention. Hum Vaccin Immunother 2021; 17:1975-1979. [PMID: 33327839 DOI: 10.1080/21645515.2020.1851130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Human papillomavirus (HPV) vaccination can prevent six types of HPV-related cancers, and approximately, 54.2% of adolescents are up-to-date with the HPV vaccine in the United States. While moderate success has been achieved with provider- and parent-focused interventions, HPV vaccination in the U.S. lags well behind desired goals. In order to maximize HPV vaccination and prevention of HPV-related cancers, it may be prudent to consider state policy approaches, such as school-entry requirements as part of the patchwork of provider, parent, and structural interventions. In this paper, we reviewed the history of efforts to implement school-entry requirements for HPV vaccine, the challenges and benefits associated with implementing these requirements, and the evidence for the effectiveness of school-entry requirements. In addition, we presented new data from Rhode Island's Immunization Information System (IIS) showing how their school-entry requirement, implemented in 2015, has impacted HPV vaccination rates. These registry data indicate that HPV vaccination rates improved significantly after the 2014-2015 school year and policy implementation, and add to the ongoing evidence supporting the value of school-entry requirements for HPV vaccination. School-entry requirements should be considered alongside other initiatives and policies for promoting HPV vaccine uptake. Taking a comprehensive systems approach to HPV vaccination is needed.
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Affiliation(s)
- Erika L Thompson
- Department of Health Behavior & Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Tricia Washburn
- Office of Immunization, State of Rhode Island Department of Health, Providence, RI, USA
| | - Kim Salisbury-Keith
- Office of Immunization, State of Rhode Island Department of Health, Providence, RI, USA
| | - Debbie Saslow
- Department of Cancer Control, American Cancer Society, Atlanta, GA, USA
| | - Holly B Fontenot
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Gregory D Zimet
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
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27
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Michel A, Ryan N, Mattheus D, Knopf A, Abuelezam NN, Stamp K, Branson S, Hekel B, Fontenot HB. Undergraduate nursing students' perceptions on nursing education during the 2020 COVID-19 pandemic: A national sample. Nurs Outlook 2021; 69:903-912. [PMID: 34183191 PMCID: PMC8514289 DOI: 10.1016/j.outlook.2021.05.004] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/14/2021] [Accepted: 05/02/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND In 2020, nursing educational programs were abruptly interrupted and largely moved online due to the COVID-19 pandemic. PURPOSE To explore nursing students' perspectives about the effects of the pandemic on their education and intention to join the nursing workforce. METHODS Undergraduate nursing students from 5 universities across 5 United States regions were invited to participate in an online survey to elicit both quantitative and qualitative data. FINDINGS The final sample included quantitative data on 772 students and qualitative data on 540 students. Largely (65.1%), students reported that the pandemic strengthened their desire to become a nurse; only 11% had considered withdrawing from school. Qualitatively, students described the effect of the pandemic on their psychosocial wellbeing, adjustment to online learning, and challenges to clinical experiences. CONCLUSION Findings highlighted the need to develop emergency education preparedness plans that address student wellbeing and novel collaborative partnerships between schools and clinical partners.
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Affiliation(s)
- Alexandra Michel
- University of Hawaii at Manoa, School of Nursing & Dental Hygiene, Honolulu, HI
| | - Nicole Ryan
- University of Hawaii at Manoa, School of Nursing & Dental Hygiene, Honolulu, HI
| | - Deborah Mattheus
- University of Hawaii at Manoa, School of Nursing & Dental Hygiene, Honolulu, HI
| | - Amelia Knopf
- Indiana University, School of Nursing, Department of Community and Health Services, Indianapolis, IN
| | | | - Kelly Stamp
- University of North Carolina at Greensboro, School of Nursing, Greensboro, NC
| | - Sandra Branson
- Cizik School of Nursing at The University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX
| | - Barbara Hekel
- Cizik School of Nursing at The University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX
| | - Holly B Fontenot
- University of Hawaii at Manoa, School of Nursing & Dental Hygiene, Honolulu, HI.
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28
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Allen JD, Abuelezam NN, Rose R, Fontenot HB. Factors associated with the intention to obtain a COVID-19 vaccine among a racially/ethnically diverse sample of women in the USA. Transl Behav Med 2021; 11:785-792. [PMID: 33769536 PMCID: PMC8083705 DOI: 10.1093/tbm/ibab014] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Widespread uptake of the COVID-19 vaccine is critical to halt the pandemic. At present, little is known about factors that will affect vaccine uptake, especially among diverse racial/ethnic communities that have experienced the highest burden of COVID. We administered an online survey to a Qualtrics respondent panel of women ages 27-45 years (N = 396) to assess vaccine intentions and attitudes, and trusted vaccine information sources. 56.8% intended to be vaccinated and 25.5% were unsure. In bivariate analyses, a greater percentage of non-Latina White (NLW) and Chinese women reported that they would be vaccinated, compared with Latina and non-Latina Black (NLB) women (p < 0.001). Those who were uninsured, unemployed and those with lower incomes were less likely to say that they would be vaccinated. In analyses stratified by race/ethnicity, NLB women remained significantly less likely to report that they would be vaccinated compared with NLW women (adjusted odds ratio: 0.47; 95% confidence interval: 0.23, 0.94), controlling for age, marital status, income, education, employment, and insurance status. When analyses were additionally controlled for beliefs in vaccine safety and efficacy, racial/ethnic differences were no longer significant (adjusted odds ratio: 0.64; 95% confidence interval: 0.31, 1.34). Given that NLB women were less likely to report the intention to be vaccinated, targeted efforts will be needed to promote vaccine uptake. It will be critical to emphasize that the vaccine is safe and effective; this message may be best delivered by trusted community members.
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Affiliation(s)
- Jennifer D Allen
- Department of Community Health, Tufts University, Medford, MA, USA
| | | | - Rebecca Rose
- Department of Community Health, Tufts University, Medford, MA, USA
| | - Holly B Fontenot
- School of Nursing & Dental Hygiene, University of Hawaii at Manoa, Honolulu, HI, USA
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29
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Fontenot HB, White BP, Rosenberger JG, Lacasse H, Rutirasiri C, Mayer KH, Zimet G. Mobile App Strategy to Facilitate Human Papillomavirus Vaccination Among Young Men Who Have Sex With Men: Pilot Intervention Study. J Med Internet Res 2020; 22:e22878. [PMID: 33146621 PMCID: PMC7673982 DOI: 10.2196/22878] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/24/2020] [Accepted: 10/09/2020] [Indexed: 01/05/2023] Open
Abstract
Background Mobile app-based interventions have been identified as potential facilitators for vaccination among young men who have sex with men (MSM). Objective This pilot study aimed to test the feasibility of a theoretically informed mobile health (mHealth) tool designed to reduce health disparities and facilitate human papillomavirus (HPV) vaccination among a sample of young MSM. Methods The development of the mHealth tool was guided by previous research, implementation intention theory, and design thinking. We recruited MSM aged 18-26 years through a popular online dating app and linked participants to our mHealth tool, which provided HPV vaccine information and fostered access to care. Results A total of 42 young MSM participated in this pilot study in Boston, Massachusetts. Participants reported variable HPV knowledge (ie, high knowledge of HPV risk factors and low knowledge of HPV-related cancer risks for men) and positive vaccine beliefs and attitudes. Of those who were either unvaccinated, not up to date, or did not report vaccine status, 23% (8/35) utilized the mHealth tool to obtain HPV vaccination. Participants primarily utilized the tool’s (1) educational components and (2) capabilities facilitating concrete vaccine action plans. Conclusions We recruited an underserved at-risk population of youth via an online dating app for our mHealth intervention that resulted in in-person health care delivery. This study was limited by enrollment challenges, including low willingness to download the mHealth tool to mobile devices.
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Affiliation(s)
- Holly B Fontenot
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, Honolulu, HI, United States.,The Fenway Institute, Boston, MA, United States.,Connell School of Nursing, Boston College, Chestnut Hill, MA, United States
| | | | - Joshua G Rosenberger
- College of Health and Human Development, Penn State University, University Park, PA, United States
| | - Hailee Lacasse
- Connell School of Nursing, Boston College, Chestnut Hill, MA, United States
| | - Chokdee Rutirasiri
- Proper Villains, Boston, MA, United States.,School of Arts and Sciences, Boston College, Chestnut Hill, MA, United States
| | - Kenneth H Mayer
- The Fenway Institute, Boston, MA, United States.,Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States.,School of Medicine, Harvard University, Boston, MA, United States
| | - Gregory Zimet
- Division of Adolescent Medicine, School of Medicine, Indiana University, Indianapolis, IN, United States
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30
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McKay EA, Fontenot HB. Parent-Adolescent Sex Communication with Sexual and Gender Minority Youth: An Integrated Review. J Pediatr Health Care 2020; 34:e37-e48. [PMID: 32861429 DOI: 10.1016/j.pedhc.2020.04.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/03/2020] [Accepted: 04/13/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Sexual and gender minority (SGM) youth experience adverse sexual health outcomes at higher rates than their heterosexual and cisgender peers. Although parent-adolescent sex communication (PASC) is associated with improved sexual health outcomes among heterosexual youth, less is known about PASC with SGM youth. METHODS Studies describing experiences of SGM youth and parents during PASC and/or health outcomes of PASC were reviewed. RESULTS Eleven studies met inclusion criteria, and six themes emerged. These included: (1) limited communication and barriers to communication, (2) impact of SGM disclosure on communication, (3) HIV and/or sexually transmitted disease-focused communication, (4) heteronormative communication, (5) outcomes of communication, and (6) youth preferences for PASC. DISCUSSION Parent-adolescent sex communication was complicated by barriers to communication and was limited, heteronormative, and influenced by SGM disclosure. Parent-adolescent sex communication may improve sexual health outcomes, but adequate parental education and guidance is lacking. This review identifies ways that health providers can foster positive and inclusive PASC.
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31
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White BP, Abuelezam NA, Dwyer AA, Fontenot HB. A sexual health course for advanced practice registered nurses: Effect on preparedness, comfort, and confidence in delivering comprehensive care. Nurse Educ Today 2020; 92:104506. [PMID: 32599471 DOI: 10.1016/j.nedt.2020.104506] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 05/01/2020] [Accepted: 06/14/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Sexual healthcare is a critical component of well-being. Sexual health disparities persist nationally. Nurses and advanced practice nurses are well positioned to provide sexual healthcare to diverse patient populations. However, many nurses do not feel prepared to provide comprehensive care and sexual health curricula vary widely across schools of nursing. OBJECTIVES We aimed to evaluate the effectiveness of a new sexual health course for graduate students in improving nurses' knowledge, preparedness, comfort, and confidence in delivering comprehensive, culturally informed sexual healthcare. DESIGN A pre-post-intervention survey study design was utilized to assess course effectiveness. SETTING Medium-sized, private university. PARTICIPANTS Graduate nursing students enrolled in the course (intervention group, n = 30) were recruited. Graduate students enrolled at the institution but not enrolled in the course served as controls (n = 64). METHODS Descriptive statistics and multivariate analysis were used to evaluate pre- to post-course changes in knowledge, preparedness, comfort, and confidence in the intervention group and differences between the intervention and control group at baseline. RESULTS At baseline, all participants (n = 94) exhibited high objective clinical sexual health knowledge. The intervention group had significantly increased overall preparedness, comfort, and confidence in providing sexual healthcare to diverse patient populations. In particular, participants in the intervention group had statistically significant increases associated with care for marginalized minority populations (sexual minorities, gender minorities, sex workers, and persons with a history of sexual trauma). CONCLUSIONS The graduate-level course on sexual health and sexual health disparities effectively increased perceived preparedness, comfort, and confidence in delivering comprehensive and culturally informed care to diverse populations. Nursing programs should evaluate their curricula to determine whether graduates are optimally prepared.
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Affiliation(s)
- Bradley Patrick White
- Boston College, Connell School of Nursing, Chestnut Hill, MA, United States of America
| | - Nadia A Abuelezam
- Boston College, Connell School of Nursing, Chestnut Hill, MA, United States of America
| | - Andrew A Dwyer
- Boston College, Connell School of Nursing, Chestnut Hill, MA, United States of America; Yvonne L. Munn Center for Nursing Research, Massachusetts General Hospital, Boston, MA, United States of America
| | - Holly B Fontenot
- Boston College, Connell School of Nursing, Chestnut Hill, MA, United States of America; The Fenway Institute, Boston, MA, United States of America; University of Hawaii at Manoa, School of Nursing and Dental Hygiene, Honolulu, HI, United States of America.
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32
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Fontenot HB, Cahill SR, Wang T, Geffen S, White BP, Reisner S, Conron K, Harper CR, Johns MM, Avripas SA, Michaels S, Dunville R. Transgender Youth Experiences and Perspectives Related to HIV Preventive Services. Pediatrics 2020; 145:peds.2019-2204. [PMID: 32184336 DOI: 10.1542/peds.2019-2204] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In the United States, transgender youth are at especially high risk for HIV infection. Literature regarding HIV prevention strategies for this vulnerable, often-hidden population is scant. Before effective, population-based HIV prevention strategies may be adequately developed, it is necessary to first enhance the contextual understanding of transgender youth HIV risk and experiences with HIV preventive services. METHODS Two 3-day, online, asynchronous focus groups were conducted with transgender youth from across the United States to better understand participant HIV risk and experiences with HIV preventive services. Participants were recruited by using online advertisements posted via youth organizations. Qualitative data were analyzed by using content analysis. RESULTS A total of 30 transgender youth participated. The average age was 18.6 years, and youth reported a wide range of gender identities (eg, 27% were transgender male, 17% were transgender female, and 27% used ≥1 term) and sexual orientations. Four themes emerged: (1) barriers to self-efficacy in sexual decision-making; (2) safety concerns, fear, and other challenges in forming romantic and/or sexual relationships; (3) need for support and education; and (4) desire for affirmative and culturally competent experiences and interactions (eg, home, school, and health care). CONCLUSIONS Youth discussed experiences and perspectives related to their gender identities, sexual health education, and HIV preventive services. Findings should inform intervention development to improve support and/or services, including the following: (1) increasing provider knowledge and skills to provide gender-affirming care, (2) addressing barriers to services (eg, accessibility and affordability as well as stigma and discrimination), and (3) expanding sexual health education to be inclusive of all gender identities, sexual orientations, and definitions of sex and sexual activity.
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Affiliation(s)
- Holly B Fontenot
- The Fenway Institute, Fenway Health, Boston, Massachusetts; .,W.F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts
| | - Sean R Cahill
- The Fenway Institute, Fenway Health, Boston, Massachusetts.,School of Public Health, Boston University, Boston, Massachusetts; and.,Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts
| | - Timothy Wang
- The Fenway Institute, Fenway Health, Boston, Massachusetts
| | - Sophia Geffen
- The Fenway Institute, Fenway Health, Boston, Massachusetts
| | - Bradley P White
- W.F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts
| | - Sari Reisner
- The Fenway Institute, Fenway Health, Boston, Massachusetts.,Division of Endcrinology, Diabetes, and Hypertension, Brigham and Women's Hosptial, Boston, Massachusetts
| | - Kerith Conron
- The Fenway Institute, Fenway Health, Boston, Massachusetts.,The Williams Institute on Sexual Orientation and Gender Identity Law and Public Policy, University of California, Los Angeles, Los Angeles, California
| | - Christopher R Harper
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Michelle M Johns
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Fontenot HB, Abuelezam NN, Rosenberger JG, Novak D, Mayer KH, Zimet G. The Impact of Advertisement Messaging on Enrollment of Young Men Who Have Sex With Men for Web-Based Research: Observational Study. J Med Internet Res 2020; 22:e16027. [PMID: 31929103 PMCID: PMC6996771 DOI: 10.2196/16027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/18/2019] [Accepted: 10/20/2019] [Indexed: 12/26/2022] Open
Abstract
Background Recruiting young men who have sex with men (YMSM) in community settings is difficult. The use of Web-based social networks and dating apps for recruitment can be successful approaches, although little work has been done on the impact of study advertisement content on recruitment. Objective The aim of this study was to evaluate the effects of advertisement message content on the recruitment of YMSM (aged 18-26 years) for a Web-based focus group study, examining perspectives and preferences for a mobile app that was designed to support sexual health among YMSM. Methods Between March and April 2017, a recruitment campaign to promote human papillomavirus vaccination was launched on a popular social networking and dating app for YMSM, with 3 different text-based advertisement themes (technology, cancer prevention, and sexual innuendo). The campaign recruited YMSM across 3 states (Massachusetts, New York, and Pennsylvania). We examined the click-through rates, conversion rates, and enrollment rates of each of the advertisements and examined differences in views and clicks by age, state, and time of day. Results The sexual innuendo advertisement had the highest click rates when compared with both the technology (click rate ratio [CRR] 2.06, 95% CI 1.74-2.45) and cancer prevention (CRR 1.62, 95% CI 1.38-1.90) advertisements. The sexual innuendo advertisement also had higher study enrollment rates compared with the technology (CRR 1.90, 95% CI 1.23-2.83) and cancer prevention (CRR 2.06, 95% CI 1.37-3.13) advertisements. No differences were observed in clicks or enrollment by age, state, or time of day. Conclusions Our marketing campaign, targeting YMSM, was effective in recruiting participants for a qualitative study, using Web-based focus groups. The sexual innuendo advertisement was the most effective and cost-efficient advertisement of the 3 approaches trialed. Different populations need different targeted strategies for study recruitment. Researchers should work with key representatives to develop and test culturally relevant messaging and approaches that utilize current and popular technologies.
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Affiliation(s)
- Holly B Fontenot
- Connell School of Nursing, Boston College, Chestnut Hill, MA, United States.,The Fenway Institute, Boston, MA, United States
| | - Nadia N Abuelezam
- Connell School of Nursing, Boston College, Chestnut Hill, MA, United States
| | - Joshua G Rosenberger
- Department of Biobehavioral Health, Penn State University, University Park, PA, United States
| | - David Novak
- DSN Consulting, LLC, Quincy, MA, United States
| | - Kenneth H Mayer
- The Fenway Institute, Boston, MA, United States.,Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Gregory Zimet
- Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
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White BP, Fontenot HB. Transgender and non-conforming persons' mental healthcare experiences: An integrative review. Arch Psychiatr Nurs 2019; 33:203-210. [PMID: 30927991 DOI: 10.1016/j.apnu.2019.01.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 12/20/2018] [Accepted: 01/19/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Transgender and gender non-conforming (TGNC) people in the United States face disproportionate rates of mental health disorders, including suicidality, depression, anxiety, and substance use disorders than the general population. Patients' experiences utilizing mental healthcare is a determinant in their care-seeking behaviors and treatment success. AIM/QUESTION The purpose of this integrative review is to better understand the firsthand mental healthcare experiences of TGNC persons. METHOD The authors sought to locate recent English-language articles that described the mental healthcare experiences of TGNC persons. To do so, only articles that conducted data collection with a TGNC sample were considered for review. RESULTS Seven articles met criteria for review. Four themes emerged that depicted experiences of health promotion (welcoming environments, staff knowledge and response) and health prevention (enacted stigma, racial disparities and intersectional insensitivity). DISCUSSION Themes indicated that TGNC persons have mixed experiences (excellent to harmful/damaging) when receiving mental healthcare. There is room for healthcare provider growth in skills to increase TGNC cultural competency. IMPLICATIONS FOR PRACTICE Mental healthcare providers and nurses would benefit from interventions to promote TGNC culturally competent care, including in-service training or continuing education for the current work force as well as incorporating TGNC content into pre-licensure educational curricula.
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Affiliation(s)
- Bradley Patrick White
- Boston College, W.F. Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, United States of America.
| | - Holly B Fontenot
- Boston College, W.F. Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, United States of America
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Fontenot HB, Rosenberger JG, McNair KT, Mayer KH, Zimet G. Perspectives and preferences for a mobile health tool designed to facilitate HPV vaccination among young men who have sex with men. Hum Vaccin Immunother 2019; 15:1815-1823. [PMID: 30625049 DOI: 10.1080/21645515.2019.1568156] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
We sought to understand young men who have sex with men (YMSM) perspectives and preferred features for a mobile health (mHealth) tool designed to facilitate human papillomavirus (HPV) vaccination. YMSM were recruited on a popular social/sexual networking app to participate in online focus groups. Discussions were designed to elicit what the men would want in a mHealth tool specific for sexual health and HPV. Demographic data were analyzed using descriptive statistics and focus group data were analyzed using conventional content analysis. Forty-eight YMSM participated. Mean age was 23.4 years, and 70.0% reported their race as Black. Qualitative themes included general HPV knowledge and awareness, current patterns in technology use, desired app qualities, and desired app content. Youth described varying levels of HPV knowledge, utilized apps to engage socially, and for travel, banking, gaming, news and entertainment, and few used apps to facilitate personal health or engage with healthcare systems. Participants desired credible, relatable, secure, and easy to use interfaces that provided sexual health and HPV information in a positive context. They described ways to creatively engage and directly connect youth to health providers. We identified a culturally relevant youth driven approach to facilitate HPV vaccination and sexual health among YMSM.
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Affiliation(s)
- Holly B Fontenot
- a Connell School of Nursing, Boston College , Chestnut Hill , MA , USA.,b Fenway Health/The Fenway Institute , Boston , MA , USA
| | - Joshua G Rosenberger
- c Department of Behavioral Health, Penn State University , University Park , PA , USA
| | - Katelyn T McNair
- a Connell School of Nursing, Boston College , Chestnut Hill , MA , USA
| | - Kenneth H Mayer
- b Fenway Health/The Fenway Institute , Boston , MA , USA.,d Beth Israel Deaconess Medical Center, Department of Medicine, Boston MA/Harvard Medical School , Boston , MA , USA
| | - Gregory Zimet
- e Section of Adolescent Medicine, Indiana University School of Medicine , Indianapolis , IN , USA
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Wheldon CW, Sutton SK, Fontenot HB, Quinn GP, Giuliano AR, Vadaparampil ST. Physician Communication Practices as a Barrier to Risk-Based HPV Vaccine Uptake Among Men Who Have Sex with Men. J Cancer Educ 2018; 33:1126-1131. [PMID: 28456947 PMCID: PMC7771357 DOI: 10.1007/s13187-017-1223-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The Advisory Committee on Immunization Practices recommends that men who have sex with men (MSM) 26 years of age or younger be routinely vaccinated against HPV. For men outside of this risk-based population, the recommendation is routine vaccination until age 21. Thus, in order for this risk-based recommendation for MSM to be implemented, two distinct actions need to be completed during the clinical visit: (1) discuss recommendations for HPV vaccination with men and (2) assess sexual orientation to determine if a risk-based recommendation should be made. We assessed the degree to which physicians routinely discussed issues of sexual orientation and HPV vaccination with male patients 22-26 years old. We used data from a statewide representative sample of 770 primary care physicians practicing in Florida who were randomly selected from the American Medical Association Physician Masterfile. The analytic sample consisted of physicians who provided care to men 22-26 years old (N = 220). Response rate was 51%. Data collection took place in 2014 and analyses in 2016. Only 13.6% of physicians were routinely discussing both sexual orientation and HPV vaccination with male patients 22-26 years old, and approximately a quarter (24.5%) were not discussing either. Differences in these behaviors were found based on gender, Hispanic ethnicity, availability of HPV vaccine in clinic, HPV-related knowledge, and specialty. A minority of physicians in this sample reported engaging with these patients in ways that are mostly likely to result in recommendations consistent with current Advisory Committee on Immunization Practices guidelines.
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Affiliation(s)
- Christopher W. Wheldon
- Department of Community and Family Health, University of South Florida, 13210 Bruce B. Downs Blvd., MDC56, Tampa, FL 33612-3805, USA
| | - Steven K. Sutton
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Gwendolyn P. Quinn
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA
| | - Anna R. Giuliano
- Division of Population Science, Moffitt Cancer Center, Tampa, FL, USA
| | - Susan T. Vadaparampil
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA
- Moffitt Cancer Center, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL 33612, USA
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Katigbak C, Fontenot HB. A Primer on the New Guideline for the Prevention, Detection, Evaluation, and Management of Hypertension. Nurs Womens Health 2018; 22:346-354. [PMID: 30077241 DOI: 10.1016/j.nwh.2018.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/04/2018] [Accepted: 05/01/2018] [Indexed: 01/14/2023]
Abstract
Hypertension is a leading risk factor for the development of cardiovascular disease. In 2017, the American College of Cardiology and the American Heart Association published a new guideline for the prevention, detection, evaluation, and management of hypertension. The guideline adjusts the clinical parameters for diagnosis and management of hypertension. In this article we summarize the updates and provide some background on these changes as they relate to nursing practice implications, with specific implications for women's health.
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Apaydin KZ, Fontenot HB, Shtasel DL, Mayer KH, Keuroghlian AS. Primary Care Provider Practices and Perceptions Regarding HPV Vaccination and Anal Cancer Screening at a Boston Community Health Center. J Community Health 2018; 43:792-801. [PMID: 29480339 PMCID: PMC6033675 DOI: 10.1007/s10900-018-0486-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Human papillomavirus (HPV) vaccination and anal cancer screening are valuable, yet underutilized, tools in prevention of HPV-related cancers among sexual and gender minority (SGM) populations. The aim of this study was to characterize primary care providers' (PCPs) practices and perceptions pertaining to HPV vaccination and anal cancer screening. A survey assessing self-reported practice characteristics related to HPV vaccination and anal cancer screening, as well as perceived barriers to vaccination and anal cancer screening at the patient-, provider-, and system-level was distributed to PCPs at a Federally-Qualified Health Center that specializes in care for SGM populations in the greater Boston area. A total of 33 PCPs completed the survey. All PCPs strongly recommended HPV vaccination to their patients by emphasizing that the vaccine is extremely important or very important. Most PCPs told their patients that the HPV vaccine prevents cervical cancer (96.9%), anal cancer (96.9%), oropharyngeal cancer (72.7%), penile cancer (57.5%), and genital warts (63.6%). There is substantial variability among providers regarding recommendations for anal cancer screening and follow-up. Most PCPs perceived that patient-level factors such as poverty, mental illness, and substance use disorders were barriers to HPV vaccination and anal cancer screening. Systems-level barriers such as lack of clinical time with each patient and lack of staffing were also described as barriers to vaccination and screening. Patient-, provider- and systems-level improvements are important to increase HPV vaccination and anal cancer screening rates.
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Affiliation(s)
- Kaan Z Apaydin
- The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, USA
| | - Holly B Fontenot
- The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, USA
- W.F. Connell School of Nursing, Boston College, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA
| | - Derri L Shtasel
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, USA
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, USA
| | - Alex S Keuroghlian
- The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, USA.
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
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Apaydin KZ, Fontenot HB, Borba CPC, Shtasel DL, Ulery S, Mayer KH, Keuroghlian AS. Three-dose HPV vaccine completion among sexual and gender minority young adults at a Boston community health center. Vaccine 2018; 36:4897-4903. [PMID: 29983254 DOI: 10.1016/j.vaccine.2018.06.057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/24/2018] [Accepted: 06/26/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Disparities in human papillomavirus (HPV) vaccination completion have been noted among sexual and gender minority (SGM) people. Little is known about factors associated with HPV vaccination among SGM people. This study examines factors linked with completion of HPV vaccination among SGM patients. METHODS We collected cross-sectional data from electronic health records (EHRs) of SGM patients receiving primary care at a Boston community health center specialized in SGM health. We employed a binomial logistic regression model to identify factors associated with 3-dose HPV vaccine completion. RESULTS Patients were 70.3% white, with mean age of 26.3 years (SD = 2.48), 26.9% identifying as gender minorities and 79% as sexual minorities, 48.9% with 4-year college or graduate degrees, 59.4% employed, 65.9% with private insurance, 39.1% living at or below the federal poverty level, and 8.3% living with HIV. Seventy-seven percent of patients who were offered HPV vaccination had completed the series. Factors significantly associated with HPV vaccine completion included: 4-year college or graduate degree (OR: 2.87; 95% CI = 1.26-6.53), completion of primary care appointments (OR: 1.03; 95% CI: 1.01-1.05), Hepatitis A or B vaccine completion (OR: 2.59; 95% CI: 1.2-5.59), and visits for a sexually transmitted infection (STI) screen (OR: 1.22; 95% CI: 1.03-1.43). CONCLUSION Vaccine completion was higher among SGM with higher levels of education, Hepatitis A or B vaccination, and completed health visits. These findings highlight potential ways to increase HPV vaccination, such as offering tailored HPV vaccine education, bundling with other vaccines, and incorporating HPV vaccination with STI screenings.
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Affiliation(s)
| | | | - Christina P C Borba
- Boston University, School of Medicine and Boston Medical Center, United States
| | - Derri L Shtasel
- Harvard Medical School and Massachusetts General Hospital, United States
| | | | - Kenneth H Mayer
- The Fenway Institute, Beth Israel Deaconess Medical Center, United States
| | - Alex S Keuroghlian
- The Fenway Institute, Harvard Medical School, and Massachusetts General Hospital, United States.
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Apaydin KZ, Fontenot HB, Shtasel D, Dale SK, Borba CPC, Lathan CS, Panther L, Mayer KH, Keuroghlian AS. Facilitators of and barriers to HPV vaccination among sexual and gender minority patients at a Boston community health center. Vaccine 2018; 36:3868-3875. [PMID: 29778516 DOI: 10.1016/j.vaccine.2018.02.043] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 02/06/2018] [Accepted: 02/08/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Young sexual minority individuals have lower human papillomavirus (HPV) vaccine completion rates than the general population, and little is known about how gender minority people perceive HPV vaccination. The aim of this study was to qualitatively identify patient-, provider-, and systems-level barriers and facilitators for HPV vaccination among sexual and gender minority (SGM) people. METHODS Fifteen SGM-identified individuals, ages 23-26, were recruited at an urban community health center in Boston, MA, that specializes in care for SGM. Participants were enrolled in a study that utilized surveys and in-person focus groups. During focus groups, participants were asked to describe their perceived barriers and facilitators for completion of HPV vaccination. RESULTS Fourteen participants reported having a sexual minority identity, and five participants reported having a gender minority identity. Participants described the following factors influencing HPV vaccination: (1) at the patient level, low HPV-related knowledge and lack of engagement in care were associated with less vaccination, whereas fear of HPV-related disease motivated vaccination; (2) at the provider level, knowledge and SGM cultural-competence related to HPV was associated with patient willingness to be vaccinated; (3) at the systems level, SGM identity-affirming healthcare settings were associated with increased vaccination, whereas historical trends in HPV vaccine marketing selectively for cisgender women and lack of public awareness of HPV-related disease among SGM were associated with decreased vaccincation. CONCLUSION Our study identified internal and external barriers for HPV vaccination related among SGM patients. These findings highlight the need to increase public awareness about the risks of HPV-related disease among SGM and educate SGM youth about HPV-related disease and vaccine importance. Finally, this study supports the need for future interventions to cultivate SGM-competent providers and SGM identity-affirming healthcare settings as a way to increase HPV vaccination.
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Affiliation(s)
| | | | - Derri Shtasel
- Harvard Medical School and Massachusetts General Hospital, United States
| | - Sannisha K Dale
- University of Miami and Massachusetts General Hospital, United States
| | - Christina P C Borba
- Boston University School of Medicine and Boston Medical Center, United States
| | | | | | - Kenneth H Mayer
- The Fenway Institute, Beth Israel Deaconess Medical Center, United States
| | - Alex S Keuroghlian
- The Fenway Institute, Harvard Medical School, and Massachusetts General Hospital, United States.
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Kornides ML, Fontenot HB, McRee AL, Panozzo CA, Gilkey MB. Associations between parents' satisfaction with provider communication and HPV vaccination behaviors. Vaccine 2018; 36:2637-2642. [PMID: 29627236 DOI: 10.1016/j.vaccine.2018.03.060] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/21/2018] [Accepted: 03/22/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Despite increasing awareness of the importance of a provider recommendation for HPV vaccine, the U.S. has yet to achieve the Healthy people 2020 goal of 80% series completion among adolescents. This failure indicates a need for further examination of the modifiable influences on parents' decision-making. Healthcare providers can influence parents' HPV vaccination decision-making, but little is known about parents' perspectives on the counseling they receive. We sought to assess U.S. parents' satisfaction with provider communication about HPV vaccine and associations with vaccination behaviors. METHODS Parents of 11-to-17-year-old adolescents who discussed HPV vaccination with a healthcare provider at least once (n = 795) completed our online survey in Fall 2016. We assessed their satisfaction with the discussion using the HPV Vaccine Communication Satisfaction Scale (α = 0.94). We examined associations between satisfaction (categorized as low, moderate, or high), and three vaccination behaviors: refusal/delay, series initiation (≥1 dose), and continuation (≥2 doses among initiators) using multivariable logistic regression. RESULTS Most parents reported high (36%) or moderate (38%) satisfaction with provider communication about HPV vaccination; fewer reported low (26%) satisfaction. Moderately satisfied parents (vs. low) had lower odds of refusal/delay (aOR = 0.59, 95% CI: 0.38-0.89), and higher odds of initiation (aOR = 1.71, 95% CI:1.15-2.55) and continuation (aOR = 2.05, 95% CI: 1.24-3.40). The associations were stronger for highly satisfied parents (refusal/delay aOR = 0.45, 95% CI: 0.29-0.70, initiation aOR = 3.59, 95% CI: 2.23-5.78, and continuation aOR = 4.08, 95% CI: 2.38-7.01). CONCLUSIONS Our study suggests that parent satisfaction with provider communication may play an important role in HPV vaccination decision-making. Yet, communication satisfaction has been largely unexamined in the HPV-vaccine literature to date. We introduce a brief, 7-item HPV Vaccine Communication Scale that can be used to assess parents' level of satisfaction with their provider's communication specific to HPV vaccine. We identify communication areas for providers to prioritize when discussing HPV vaccine with parents.
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Affiliation(s)
- Melanie L Kornides
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA 02215, USA.
| | - Holly B Fontenot
- WF Connell School of Nursing, Boston College, 140 Commonwealth Ave, Chestnut Hill, MA 02467, USA.
| | - Annie-Laurie McRee
- Department of Pediatrics, University of Minnesota, 1932K (Campus Delivery Code) 717 Delaware St SE, Minneapolis, MN 55414, USA.
| | - Catherine A Panozzo
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA 02215, USA.
| | - Melissa B Gilkey
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Campus Box 7440, Chapel Hill, NC 27599, USA.
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McNair KT, Fontenot HB. Understanding the Two-Dose HPV Vaccine Schedule. Nurs Womens Health 2018; 22:175-180. [PMID: 29628056 DOI: 10.1016/j.nwh.2018.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 01/10/2018] [Indexed: 06/08/2023]
Abstract
Recent advances in human papillomavirus (HPV) science have led to updates to national HPV vaccine recommendations. This column takes a second look at two recent studies that provide evidence to support the current two-dose HPV vaccination schedule for youth ages 9 to 14 years. This short review will help nurses and other clinicians understand the health and economic benefits of the current dosing recommendation. Nurses are leaders in national vaccination efforts; therefore, it is vital that they remain up to date on the latest evidence that supports vaccination practice as well as health counseling and HPV vaccine recommendations.
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Abuelezam NN, Fontenot HB. Depression Among Arab American and Arab Immigrant Women in the United States. Nurs Womens Health 2017; 21:395-399. [PMID: 28987212 DOI: 10.1016/j.nwh.2017.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 06/29/2017] [Indexed: 06/07/2023]
Abstract
The difficult and tense political climate Arab populations are currently facing may be exacerbating mental health issues, reducing forms of social support in friend circles, and decreasing the desire to seek health care. There is room to better understand the mental health needs of Arab women residing in the United States and to develop policies and interventions that keep these women safe and in care. This column reviews two recent studies; the first examines barriers to reporting intimate partner violence and depression among Arab American women and the second highlights stressors and social support for Arab women immigrants throughout their immigration experience.
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Fontenot HB, Fantasia HC, Vetters R, Zimet GD. Increasing HPV vaccination and eliminating barriers: Recommendations from young men who have sex with men. Vaccine 2016; 34:6209-6216. [PMID: 27838067 DOI: 10.1016/j.vaccine.2016.10.075] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 10/20/2016] [Accepted: 10/28/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND There is a disparity in HPV vaccination rates in particular among young men who have sex with men (YMSM) and until very recently there has been a dearth of research examining factors related to HPV vaccination for YMSM. The purpose of this study was to elicit YMSM's beliefs about HPV and the HPV vaccine as well as describe perceived barriers and facilitators of vaccine initiation and completion. METHODS A qualitative, descriptive study that utilized a focus group design was conducted among an urban and racially diverse sample of YMSM. Questionnaire data were analyzed using descriptive statistics, and focus group data were analyzed using content analysis. FINDINGS 34 YMSM with a mean age of 20.8years participated. The sample was diverse, with the largest proportion of youth identifying as Black (35.4%). Over 90% reported having an annual exam each year, 61.8% reported obtaining a flu vaccine during the past year, and 58.8% reported initiating the HPV vaccine 3-dose series. Themes identified included low HPV knowledge and awareness, positive vaccine beliefs, perceived stigmas, and HPV vaccine facilitators. Participants identified 3 ways health providers/ researchers could facilitate vaccination: creative use of mobile technology, bundling vaccination with other health services, and increasing HPV and HPV vaccine awareness. CONCLUSIONS Our findings point to some clear avenues to pursue in research and practice to improve HPV vaccination rates among YMSM, including increased use of mobile health strategies, making HPV vaccination a co-occurring part of other health-related services (e.g., HIV testing), and providing information on the relevance of HPV and HPV vaccination to YMSM.
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Affiliation(s)
- Holly B Fontenot
- Boston College, W.F. Connell School of Nursing, Chestnut Hill, MA 02467, United States; The Fenway Institute, 1340 Boylston St., Boston, MA 02215, United States; Fenway Health/Sidney Borum Jr. Health Center, 75 Kneeland St., Boston, MA 02111, United States.
| | - Heidi C Fantasia
- University of Massachusetts Lowell, College of Health Sciences, School of Nursing, 113 Wilder Street, Lowell, MA 01854, United States.
| | - Ralph Vetters
- Fenway Health/Sidney Borum Jr. Health Center, 75 Kneeland St., Boston, MA 02111, United States.
| | - Gregory D Zimet
- Indiana University School of Medicine, Department of Pediatrics, Section of Adolescent Medicine, 410 West 10th St., Indianapolis, IN 46202, United States.
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Fontenot HB, Domush V, Zimet GD. Parental Attitudes and Beliefs Regarding the Nine-Valent Human Papillomavirus Vaccine. J Adolesc Health 2015; 57:595-600. [PMID: 26592327 DOI: 10.1016/j.jadohealth.2015.09.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 09/24/2015] [Accepted: 09/24/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of the study was to explore parents' attitudes and beliefs about the nine-valent human papillomavirus vaccine (HPV9). METHODS Online focus groups were conducted in January, 2015. The U.S. national sample of parents was recruited to four groups: (1) two groups of parents of HPV unvaccinated daughters aged 9-12 years and (2) two groups of parents of vaccinated daughters aged 11-17 years. RESULTS Participants were 43 parents of vaccinated daughters and 38 parents of unvaccinated daughters. Results indicated low and variable levels of knowledge about HPV, related cancers, and vaccination (e.g., parents unaware vaccine is recommended for boys). Parents were encouraged that HPV9 covered more types, and many said they want the "better" vaccine. Parents of unvaccinated girls wondered whether they should delay vaccination until HPV9 was available, whereas parents of vaccinated girls wondered whether their daughters could be revaccinated with HPV9. Concerns were related to adverse reactions and side effects, whether another new vaccine will be released after HPV9, HPV mutation (i.e., will HPV types change over time--thereby necessitating multiple vaccines?), and cost. Physician recommendation was identified as the most important facilitator of vaccination, with participants wanting providers to exhibit high levels of confidence in and knowledge about HPV vaccines. Last, parents also viewed the prospective idea of a 2-dose HPV9 vaccine as positive. CONCLUSIONS HPV9 recently became available in the United States and has the potential to offer greater cancer prevention if widespread acceptance and uptake occur. Understanding parental perceptions and questions about HPV9 will be important for clinical messaging about this vaccine.
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Affiliation(s)
- Holly B Fontenot
- Boston College, W.F. Connell School of Nursing, Chestnut Hill, Massachusetts.
| | - Vanessa Domush
- Boston College, W.F. Connell School of Nursing, Chestnut Hill, Massachusetts; Complete Women Care, Long Beach, California
| | - Gregory D Zimet
- Department of Pediatrics, Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, Indiana
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Fontenot HB, Fantasia HC, Sutherland MA, Lee-St John T. HPV and HPV vaccine information among a national sample of college and university websites. J Am Assoc Nurse Pract 2015; 28:218-23. [PMID: 26465808 DOI: 10.1002/2327-6924.12312] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 08/27/2015] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND PURPOSE To describe the availability of human papillomavirus (HPV) and HPV vaccine information accessible to college students via official college and university websites. METHODS A review and analysis of HPV and HPV vaccination information abstracted from a national sample (n = 214) of college/university websites. Three abstractors systematically evaluated quality and quantity of vaccination, sexual health, and HPV disease information from health service webpages. CONCLUSIONS The majority of colleges/universities had designated student health service webpages (n = 181). Of these, 86% provided information on vaccinations, but less than 50% mentioned HPV or the HPV vaccine specifically and only 32% provided any HPV educational information. Colleges/university webpages that provide sexual health and or general vaccination information had higher odds of providing information on HPV and HPV vaccination. IMPLICATIONS FOR PRACTICE Nurse practitioners who care for college-aged persons need to be cognizant of the many ways they can promote HPV vaccination. Providing accurate information about resources available at student health centers is a way to promote health on campus; the findings from this study indicate that HPV and HPV vaccine information may be lacking on many college/university websites.
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Affiliation(s)
- Holly B Fontenot
- W.F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts
| | - Heidi Collins Fantasia
- College of Health Sciences, School of Nursing University of Massachusetts Lowell, Lowell, Massachusetts
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Abstract
INTRODUCTION Female college students, aged 18-25 years, are at high risk for sexual violence compared with women of other age groups. Lack of clear consent is a preceding and defining component of forced sex and sexual violence. This study explored the association between sexual consent awareness, attitudes, and beliefs and a history of forced sex among a sample of college women. In addition, the level of alcohol use among this group was examined. METHODS A cross-sectional electronic survey was sent to approximately 5900 female students enrolled at a large public university in the northeastern United States. Sexual consent was measured with the Sexual Consent Scale-Revised, and alcohol use was measured with the Alcohol Use Disorders Identification Test-Consumption Items. Logistic regression models were used to examine the differences in sexual consent scores based on a history of forced sex. RESULTS The final sample included 925 students. Twenty-two percent of participants reported a history of forced sex; more than half (59%) reported alcohol use before sexual activity. Women with greater awareness of sexual consent were significantly more likely to have a history of forced sex. Women who utilize more nonverbal, indirect approaches to communicating sexual consent were significantly less likely to have a history of forced sex compared with women with no history of forced sex. DISCUSSION These findings highlight high rates of forced sex and alcohol use in a sample of college women and explicate sexual consent awareness and communication behaviors associated with a history of forced sex.
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Affiliation(s)
- Heidi Collins Fantasia
- Author Affiliations: 1College of Health Sciences, School of Nursing, University of Massachusetts Lowell; 2William F. Connell School of Nursing, Boston College; and 3SRI International, Center for Education and Human Services, Education Division, Menlo Park, California
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Fontenot HB, Fantasia HC. HPV9 Vaccine for the Prevention of Human Papillomavirus-Related Cancers. Nurs Womens Health 2015; 19:365-370. [PMID: 26264802 DOI: 10.1111/1751-486x.12223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States, with approximately 79 million Americans currently infected. Persistent infection with HPV has been identified as the causative factor in the development of invasive cervical cancer as well as other oral and genital cancers in women and men. The quadravalent HPV4 vaccine has been available since 2006. In December 2014, the U.S. Food and Drug Administration (FDA) approved the HPV9 vaccine that provides coverage for five additional oncogenic strains of HPV that are not included in the first generation vaccine.
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Abstract
In 2013 and 2014, the Centers for Disease Control and Prevention (CDC) publicized its recommendations for the use of long-acting reversible contraception (LARC) (including intrauterine devices and implants) as first-line, highly effective options for pregnancy prevention. The use of LARC by adolescents has had growing support by national health and women's health organizations. Ongoing research is beginning to uncover facilitators and barriers to LARC use in adolescents. The purpose of this column is to highlight two recent U.S.-based studies in which researchers examined perspectives related to and factors associated with LARC use in adolescent and young adult women.
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